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Objective: Hemangioma is a common benign tumor in the head and neck. The therapeutic effect by conventional treatment was not very satisfactory. The purpose of this study is to explore the surgical strategy of low-temperature plasma radiofrequency in the treatment of hemangioma located in the nasal cavity, pharynx, and larynx. Methods: The clinical data of 29 cases with hemangioma in nasal cavity, pharynx, and larynx treated by low-temperature plasma radiofrequency ablation were retrospectively analyzed. The strategy of ablation before resection was performed for 16 cases of nasal capillary hemangioma. The other 13 cases of cavernous hemangioma in the pharynx and larynx were treated by the strategy of direct ablation. Results: All 29 patients underwent a successful operation with minimal intraoperative bleeding and no postoperative bleeding complications. There was no nasal septum perforation, dyspnea, dysphagia, dysphonia, or other complications. The patients were followed up for more than 3 years without recurrence. Conclusion: Low-temperature plasma radiofrequency is a practical, minimally invasive, and accurate method for treating hemangiomas in the nasal cavity, pharynx, and larynx. For capillary hemangiomas, the strategy of ablation before resection may be an effective way to reduce bleeding, and for cavernous hemangiomas, the strategy of direct ablation is a simple and efficient method. [ABSTRACT FROM AUTHOR]

Rosai–Dorfman disease (RDD) is a rare non-malignant disorder, characterized by painless multiple cervical lymphadenopathy, fever, and elevated inflammatory markers. Its diagnosis is difficult due to its rare incidence and various clinical presentations, especially in extranodal involvement. In this report, we demonstrate a patient with RDD who presented with a nasal septum and laryngeal tumor that caused dyspnea. We achieved a successful treatment outcome with combined surgical resection of the laryngeal mass and corticosteroid medication. The symptoms and tumors were resolved within 3 weeks after treatment. We reported our experiences with review of literatures. [ABSTRACT FROM AUTHOR]

Imaging of the larynx and hypopharynx is frequently requested to assess the extent of neoplasms beyond the field of view of endoscopic evaluation. The combination of optical and cross-sectional imaging allows tumors to be classified according to AJCC/UICC guidelines. A thorough understanding of laryngeal and hypopharyngeal anatomy is crucial to guide the radiological eye along the possible pathways of the spread of diseases and to guide differential diagnoses. Computed tomography (CT) has been the first cross-sectional imaging technique used to evaluate the larynx and hypopharynx; its spatial resolution combined with volumetric capability and the use of injectable contrast medium made CT the working horse in the assessment of neoplastic and inflammatory diseases. In the last two decades, magnetic resonance (MR) supported CT in the most challenging cases, when the optimal contrast resolution due to the multisequence portfolio is needed to assess the neoplastic involvement of laryngeal cartilages, paraglottic space(s), and extra laryngeal spread. The aim of this paper is to give a comprehensive radiological overview of larynx and hypopharynx complex anatomy, combining in vivo images, anatomical sections, and images of ex vivo specimens. [ABSTRACT FROM AUTHOR]

Objective: Advanced laryngeal cancers are clinically complex; there is a paucity of modern decision-making models to guide tumour-specific management. This pilot study aims to identify computed tomography-based radiomic features that may predict survival and enhance prognostication. Methods: Pre-biopsy, contrast-enhanced computed tomography scans were assembled from a retrospective cohort (n = 72) with advanced laryngeal cancers (T3 and T4). The LIFEx software was used for radiomic feature extraction. Two features: shape compacity (irregularity of tumour volume) and grey-level zone length matrix – grey-level non-uniformity (tumour heterogeneity) were selected via least absolute shrinkage and selection operator-based Cox regression and explored for prognostic potential. Results: A greater shape compacity (hazard ratio 2.89) and grey-level zone length matrix – grey-level non-uniformity (hazard ratio 1.64) were significantly associated with worse 5-year disease-specific survival (p < 0.05). Cox regression models yielded a superior C-index when incorporating radiomic features (0.759) versus clinicopathological variables alone (0.655). Conclusions: Two radiomic features were identified as independent prognostic biomarkers. A multi-centre prospective study is necessary for further exploration. Integrated radiomic models may refine the treatment of advanced laryngeal cancers. [ABSTRACT FROM AUTHOR]

Objective: To determine oncological and functional outcomes in patients with T3 and T4 laryngeal carcinoma, in which choice of treatment was based on expected laryngeal function and not T classification. Methods: Oncological outcomes (disease-specific survival and overall survival) as well as functional outcomes (larynx preservation and functional larynx preservation) were analysed. Results: In 130 T3 and 59 T4 patients, there was no difference in disease-specific survival or overall survival rates after radiotherapy (RT) (107 patients), chemoradiotherapy (36 patients) and total laryngectomy (46 patients). The five-year disease-specific survival rates were 83 per cent after RT, 78 per cent after chemoradiotherapy and 69 per cent after total laryngectomy, whereas overall survival rates were 62, 54 and 60 per cent, respectively. Five-year larynx preservation and functional larynx preservation rates were comparable for RT (79 and 66 per cent, respectively) and chemoradiotherapy (86 and 62 per cent, respectively). Conclusion: There is no difference in oncological outcome after (chemo)radiotherapy or total laryngectomy in T3 and T4 laryngeal carcinoma patients whose choice of treatment was based on expected laryngeal function. [ABSTRACT FROM AUTHOR]

Background: A pathological communication between the trachea and oesophagus – a tracheoesophageal fistula – may be congenital or acquired, benign or malignant, necessitating a multidisciplinary approach. Conservative attempts at closure of this abnormal connection are ineffective; the interposition of healthy vascular tissue offers the least chance of recurrence. Methods: Outcomes of an islanded fasciocutaneous internal mammary artery perforator flap applied for tracheoesophageal fistula management were assessed in four radiated patients with laryngeal carcinoma using retrospective records. Results: Four male patients, with an average age of 60.75 years, underwent tracheoesophageal fistula closure between September 2017 and February 2021. A left-sided second internal mammary artery perforator flap was used in all cases, with an average dimension of 10.5 × 4.5 cm. There were no complications of tracheoesophageal leak, flap issues or donor site morbidity on follow up. Conclusion: Recent advances in angiosomal territory mapping and microvascular dissection techniques, combined with an understanding of tracheoesophageal fistula pathology, have changed management perspectives in these difficult-to-treat patients. [ABSTRACT FROM AUTHOR]

Simple Summary: A total laryngectomy and/or pharyngectomy is an important therapy modality for advanced primary and recurrent laryngeal and hypopharyngeal squamous cell carcinoma. The surgical margins are an important prognostic factor. Resection margins for head and neck cancer surgery are clear >5 mm, close 1–5 mm and positive <1 mm. However, the anatomy of the larynx and hypopharynx is complex and resections are constrained by the anatomical relationship with the surrounding structures. The aim of this study is to investigate if a margin >5 mm is feasible. Clear resection margins are not always feasible in some resection surfaces in laryngeal and hypopharyngeal surgery, due to the anatomy of the larynx and tumor location. However, striving for a maximum feasible margin is still the main goal. We propose a new guideline for the maximum feasible but adequate resection margins in larynx and hypopharynx tumor surgery. Background: Resection margins are an important prognostic factor for patients with head and neck cancer. In general, for head and neck surgery, a margin >5 mm is advised by the Royal College of Pathologists. However, this cannot always be achieved during laryngeal and hypopharyngeal surgery. The aim of this study is to identify the resection surfaces and measure the maximum feasible margins per subsite. The clinical relevance of these maximum feasible resection margins were analyzed in this descriptive anatomical study. Methods: head and neck surgeons and a pathologist from the Erasmus MC performed a total laryngectomy and laryngopharyngectomy on a head and neck specimen specifically available for research. Results: For a total laryngectomy, resection margins >5 mm were not feasible for the ventral and dorsal resection surface. For a total laryngopharyngectomy, resection margins >5 mm were not feasible for the ventral, dorsal and lateral resection surface. Conclusion: Clear resection margins, defined as a margin >5 mm, are not always feasible in laryngeal and hypopharyngeal surgery, due to the anatomy of the larynx and tumor location. However, striving for a maximum feasible margin is still the main goal. We propose a new guideline for maximum feasible but adequate resection margins in larynx and hypopharynx tumor surgery. [ABSTRACT FROM AUTHOR]

Simple Summary: Achieving margins of >5 mm is challenging in the larynx and hypopharynx because resections are constrained by their complex anatomy. The aim of this study was to retrospectively assess the clinical relevance of resection margins defined by the RCP in total laryngectomies (TLs) and total laryngopharyngectomies (TLPs). Similar survival rates for close and clear margins for primary and recurrent LSCC were found. This may suggest that a margin > 5 mm is not clinically relevant in terms of survival, therefore a margin of 1–5 mm should be accepted in certain subsites. Margins < 1 mm are related to significantly worse outcomes and should be avoided. Background: Laryngeal and hypopharyngeal cancer is complex and resection margins are therefore constrained. The aim of this study was to investigate the clinical relevance of resection margins in laryngeal and hypopharyngeal surgery. Methods: A retrospective cohort study was performed for patients treated with a total laryngectomy (TL) or laryngopharyngectomy (TLP) for laryngeal or hypopharyngeal squamous cell carcinoma (LSCC and HSCC, respectively). Within the groups primary LSCC, recurrent LSCC, primary HSCC, and recurrent HSCC the relationship between the status of the resection margin according to the Royal Collage of Pathology and the recurrence and survival rates were investigated. Results: Positive resection margins were found in 54% for primary LSCC, 29% for recurrent LSCC, 62% for primary HSCC, and 44% for recurrent HSCC. For primary and recurrent LSCC, there was a linear association between total recurrence and narrowing margins (p = 0.007 resp. p = 0.008). Multivariate survival analysis for primary and recurrent LSCC showed a significantly worse disease free and disease-specific survival in case of positive margins compared to clear margins. Conclusion: Similar survival rates were recorded for close and clear margins for primary and recurrent LSCC. This may suggest that a margin > 5 mm is not clinically relevant in terms of survival. Therefore, a margin of 1–5 mm should be accepted in certain subsites. Margins < 1 mm are related to significantly worse outcomes and should be avoided. [ABSTRACT FROM AUTHOR]

Simple Summary: Laryngeal squamous cell carcinomas (LSCC) are the third most common type of head and neck cancer. Approximately 40% of LSCC cases present with locally advanced carcinomas at diagnosis. The poor prognosis is mainly attributed to late diagnosis. Biomarkers capable of predicting LSCC at early stages are needed. We identified and validated exosomal insulin-like growth factor binding protein 7 (IGFBP7) and Annexin A1 (ANXA1) as promising exosomal biomarkers for LSCC detection. Background: The lack of screening methods for LSCC is a critical issue, as treatment options and the treatment outcome greatly depend on the stage of LSCC at initial diagnosis. Therefore, the objective of this study was to identify potential exosomal serum biomarkers that can diagnose LSCC and distinguish between early- and late-stage disease. Methods: A multiplexed proteomic array was used to identify differentially expressed proteins in exosomes isolated from the serum samples of LSCC patients compared to the control group (septorhinoplasty, SRP). The most promising proteins for diagnosis and differentiation were calculated using biostatistical methods and were validated by immunohistochemistry (IHC), Western blots (WB), and ELISA. Results: Exosomal insulin-like growth factor binding protein 7 (IGFBP7) and Annexin A1 (ANXA1) were the most promising exosomal biomarkers for distinguishing between control and LSCC patients and also between different stages of LSCC (fold change up to 15.9, p < 0.001 for all). Conclusion: The identified proteins represent potentially novel non-invasive biomarkers. However, these results need to be validated in larger cohorts with a long-term follow-up. Exosomal biomarkers show a superior signal-to-noise ratio compared to whole serum and may therefore be an important tool for non-invasive biomarker profiling for laryngeal carcinoma in the future. [ABSTRACT FROM AUTHOR]

Simple Summary: Anterior commissure involvement (ACI) is an important factor in the local control of early-stage glottic squamous cell carcinoma (EGSCC). We initiated a radiotherapeutic treatment regimen focusing on ACI, which has included hyperfractionated radiotherapy since 2008. One-hundred and fifty-three patients with T1–T2 EGSCC were included in this study. Hyperfractionated radiotherapy (74.4 Gy in 62 fractions) was used for EGSCC with ACI. The 10-year overall survival and cause-specific survival rates were 72% and 97%, respectively. The 10-year local control rates were 94% for T1a, 88% for T1b, and 81% for T2 disease. Local control rates in patients with ACI were slightly better than those in patients without ACI with T1a and T1b diseases; however, the difference was not significant. The 10-year laryngeal preservation rate was 96%. In conclusion, hyperfractionated radiotherapy was effective for T1 disease with ACI but insufficient for T2 disease with ACI. Our treatment strategy resulted in excellent laryngeal preservation. Anterior commissure is involved in about 20% of early-stage glottic squamous cell carcinomas (EGSCCs). Treatment outcomes and prognostic factors for EGSCC with anterior commissure involvement (ACI) were evaluated by focusing on hyperfractionated radiotherapy (74.4 Gy in 62 fractions). One-hundred and fifty-three patients with T1–T2 EGSCC were included in this study. The median total doses for T1a, T1b, and T2 were 66, 74.4, and 74.4 Gy, respectively. Overall, 49 (32%) patients had T1a, 38 (25%) had T1b, and 66 (43%) had T2 disease. The median treatment duration was 46 days. The median follow-up duration was 5.1 years. The 10-year overall and cause-specific survival rates were 72% and 97%, respectively. The 10-year local control rates were 94% for T1a, 88% for T1b, and 81% for T2 disease. Local control rates in patients with ACI were slightly better than those in patients without ACI with T1a and T1b diseases; however, the difference was not significant. The 10-year laryngeal preservation rate was 96%. Six patients experienced grade 3 mucositis, and four patients had grade 3 dermatitis. Hyperfractionated radiotherapy was effective for T1 disease with ACI, but insufficient for T2 disease with ACI. Our treatment strategy resulted in excellent laryngeal preservation. [ABSTRACT FROM AUTHOR]

Objectives: Laryngeal squamous cell carcinoma (LSCC) is a common squamous cell carcinoma of the head and neck with no reliable diagnostic biomarkers. However, recent studies have shown that inflammation plays an essential role in tumor development, and several inflammation-based biomarkers have been shown to have prognostic value. This study aimed to investigate the auxiliary value of fibrinogen (FIB), fibrinogen degradation products (FDP), and lymphocyte/monocyte ratio (LMR) in LSCC diagnosis and prognosis. Methods: Clinical data from 218 patients recently diagnosed with LSCC and 207 diagnosed with benign laryngeal lesions (BLLs) were retrospectively reviewed. Potential diagnostic biomarkers were evaluated using univariate and multivariate analyses; receiver operating characteristic (ROC) curve analysis was used to identify cut-off values and diagnostic efficiency. Least absolute shrinkage and selection operator (LASSO) Logistic regression analysis was used to screen for independent risk factors to construct a diagnostic nomogram. The chi-squared test and Kaplan–Meier method were performed to investigate the correlation of clinicopathological characteristics and 3-year overall survival (OS) with FIB, FDP, and LMR in patients with LSCC. Results: FIB, FDP, and LMR levels were significantly different between the LSCC and BLL groups (P <.001), and all were independent risk factors for LSCC. The area under the ROC curve of the diagnostic nomogram was.894. Additionally, FIB, FDP, and LMR were correlated with some invasive clinicopathological features, and LMR ≥4.29 was associated with reduced OS (P =.038). Conclusion: FIB, FDP, and LMR demonstrated potential as biomarkers for the diagnosis and prognosis of LSCC; however, further studies are needed to confirm their efficacy. [ABSTRACT FROM AUTHOR]

Simple Summary: Vitamin D supplementation's effectiveness in reducing cancer is widely debated. The controversy may be explained by differences in 25(OH)D3 metabolism. Previous studies showed that breast cancer cells produce vitamin D3 metabolites locally, and their ability to regulate tumorigenesis is related to the presence of estrogen receptor alpha 66 (ERα66). The present study examined this process in another estrogen-dependent cancer, laryngeal cancer. This study evaluated the effects of the active vitamin D3 metabolite 24R,25(OH)2D3 on cell growth, whether these cells can produce their own secreted vitamin D3 metabolites, and whether this ability is related to the presence or absence of ERα66. To address these questions, ERα-positive (UM-SCC-12) and ERα-negative (UM-SCC-11A) laryngeal cancer cell lines were examined for the presence of ERα66; the enzymes responsible for metabolizing 25(OH)D3 (CYP24A1 and CYP27B1); the local production of 24,25(OH)2D3 and 1,25(OH)2D3; and the effect of 24R,25(OH)2D3 on cell growth and markers of metastasis. The results showed that laryngeal cancer cells express CYP24A1 and CYP27B1, produce 24,25(OH)2D3, and respond differently to 24R,25(OH)2D3, in correlation with ERα66 levels. These findings suggest that tumor cells locally produce vitamin D metabolites to regulate their growth, which must be considered when recommending vitamin D supplementation. Studies have evaluated vitamin D3's therapeutic potential in estrogen-responsive cancers, with conflicting findings. We have shown that the proliferation of breast cancer cells is regulated by 24R,25-dihydroxyvitamin D3 (24R,25(OH)2D3) depending on estrogen receptor alpha 66 (ERα66) expression, suggesting that this could also be the case for estrogen-sensitive laryngeal cancer cells. Accordingly, we examined levels of ERα isoforms in ERα66-positive UM-SCC-12 and ERα66-negative UM-SCC-11A cells and their response to 24R,25(OH)2D3. 24R,25(OH)2D3 stimulated proliferation, increased the expression of metastatic markers, and inhibited apoptosis in UM-SCC-12 cells while having the opposite effect in UM-SCC-11A cells. To evaluate if vitamin metabolites could act via autocrine/paracrine mechanisms, we assessed the expression, protein levels, and activity of vitamin D3 hydroxylases CYP24A1 and CYP27B1. Both cell types expressed both mRNAs; but the levels of the enzymes and their activities were differentially regulated by estrogen. ERα66-negative UM-SCC-11A cells produced more 24,25(OH)2D3 than UM-SCC-12 cells, but comparable levels of 1,25(OH)2D3 when treated with 25(OH)D3 These results suggest that the regulation of vitamin D3 metabolism in laryngeal cancer cells is modulated by ERα66 expression, and support a role for 24R,25(OH)2D3 as an autocrine/paracrine regulator of laryngeal cancer. The local metabolism of 25(OH)D3 should be considered when determining the potential of vitamin D3 in laryngeal cancer. [ABSTRACT FROM AUTHOR]

Background: Laryngocarcinoma (LC) is a common malignant tumor of the head and neck, accounting for 1% to 5% of human tumors. The primary objective of the present study was to evaluate the survival time of patients with LC at different sites. Methods: Information concerning patients with LC was extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2016. Results: In total, 16 255 patients with LC were selected from the SEER database. Among all patients, 80.2% were male; males also predominated in each tumor site subgroup. Most of the patients were aged between 60 and 69 years, had white ethnicity, were single, and had American Joint Committee on Cancer (AJCC) stage I cancer with T1, N0, and M0. The present study investigated the role of interventions in all LCs at different AJCC stages. Across the whole population, regardless of the intervention used, survival increased in patients at any cancer site. Conclusions: The study found that male sex, age ≥80 years, black ethnicity, single status, T4, N4, M1, and AJCC stage IV were associated with higher mortality rates at all sites of LC. Aggressive interventions, especially surgery and radiotherapy, may improve survival in patients with LC at different sites and with different AJCC stages. [ABSTRACT FROM AUTHOR]

Background: Treatment selection for squamous cell carcinoma patients aged over 84 years is controversial. This retrospective chart review examined and compared characteristics of laryngeal squamous cell carcinoma in very elderly (over 84 years) and younger patients (approximately 65 years). The secondary objective was to further evaluate the outcome of radiotherapy as a treatment modality in this patient population. Methods: Of all 23 very elderly patients with laryngeal squamous cell carcinoma treated with radiotherapy, with or without surgery, in the Davidoff Cancer Center, from 1992 to 2012, 19 had sufficient data for analysis, and comprised the study group. Results: Median age at diagnosis was 86 years. Disease stage at diagnosis was I, II, III and IVA in 53 per cent, 21 per cent, 21 per cent and 5 per cent, respectively. Median radiotherapy dose was 60 Gy given in 25 fractions. Three patients had recurrence. No patient discontinued treatment because of toxicity. Median overall survival was 3.6 years (range, 0–10 years). Conclusion: Very elderly laryngeal squamous cell carcinoma patients may derive a similar survival advantage as younger counterparts. Modern radiotherapy is effective and safe for treating laryngeal squamous cell carcinoma in this study population. Further, large-scale studies are needed. [ABSTRACT FROM AUTHOR]

A persistent tracheocutaneous fistula is a common complication of tracheostomy stoma closure, when the primary purpose of the tracheostomy has been solved. It is basically a squamous epithelium-lined tract connecting the skin to the stoma of the trachea, which forms as a sequelae of long-term tracheostomy and prevents spontaneous closure of the tract. The usual or the commonest method for this closure involves primary suturing of the stoma. But if it fails, flap closure becomes the necessity. In this article, we describe the method of closure of a persistent tracheocutaneous fistula using local random rotation skin flaps. In places where major myocutaneous flap closure is difficult to perform because of the patient's health or unavailability of proper setup, this technique becomes useful. Hence, it reduces the cost of surgery, can be done using local anesthesia, is a shorter procedure, and reduces the strain of surgery on the patient [ABSTRACT FROM AUTHOR]

To analyse the risk factors and healing factors of pharyngocutaneous fistula (PCF) in patients with laryngeal cancer after total laryngectomy, and to explore the relevant epidemiology. A retrospective analysis was conducted on laryngeal cancer patients who underwent total laryngectomy in our hospital from January 2010 to December 2022. The 349 patients included in the study were divided into a PCF group of 79 and a non‐PCF group of 270. Perform one‐way analysis of variance and multivariate logistic analysis on various data of patients included in the statistics, and analyse the risk factors and healing factors of PCF. Smoking, history of radiation therapy for laryngeal cancer, history of chemotherapy for laryngeal cancer, tumour location (larynx, pharynx, oesophagus), preoperative albumin, postoperative proteinaemia, <99 haemoglobin, postoperative haemoglobin, postoperative C‐reactive protein (CRP) level are the risk factors for PCF. Also, radiation therapy and postoperative proteinaemia were the main reasons for preventing PCF healing. Smoking history, laryngeal cancer, radiation therapy, albumin, haemoglobin and CRP are risk factors for postoperative PCF after total laryngectomy, while radiation therapy and postoperative hypoalbuminaemia are key factors affecting PCF healing. [ABSTRACT FROM AUTHOR]

Background: Pharyngocutaneous fistula is one of the most common complications following total laryngectomy. It increases hospital stay and the financial burden on patients, and prolongs nasogastric feeding. This paper presents novel techniques for prevention of pharyngocutaneous fistula. Method: A retrospective study was conducted at a tertiary referral centre to assess the effectiveness of continuous extramucosal pharyngeal suturing and the hydrogen peroxide leak test in prevention of pharyngocutaneous fistula in 59 patients who had undergone total laryngectomy with or without partial pharyngectomy for locally advanced cancers of the larynx and hypopharynx. Results: The incidence of pharyngocutaneous fistula in our study was 6.8 per cent, which is considerably lower than the incidence reported in various previous studies. Conclusion: The continuous extramucosal suturing technique provides watertight closure of the neopharynx and can be recommended as a reliable method for neopharyngeal closure post total laryngectomy to reduce the occurrence of pharyngocutaneous fistula. [ABSTRACT FROM AUTHOR]

Objective: To propose a scoring system based on laryngoscopic characteristics for the differential diagnosis of benign and malignant vocal fold leukoplakia. Methods: Laryngoscopic images from 200 vocal fold leukoplakia cases were retrospectively analysed. The laryngoscopic signs of benign and malignant vocal fold leukoplakia were compared, and statistically significant features were assigned and accumulated to establish the leukoplakia finding score. Results: A total of five indicators associated with malignant vocal fold leukoplakia were included to construct the leukoplakia finding score, with a possible range of 0–10 points. A score of 6 points or more was indicative of a diagnosis of malignant vocal fold leukoplakia. The sensitivity, specificity and accuracy values of the leukoplakia finding score were 93.8 per cent, 83.6 per cent and 86.0 per cent, respectively. The consistency in the leukoplakia finding score obtained by different laryngologists was strong (kappa = 0.809). Conclusion: This scoring system based on laryngoscopic characteristics has high diagnostic value for distinguishing benign and malignant vocal fold leukoplakia. [ABSTRACT FROM AUTHOR]

There are few adequate randomized clinical trials directly comparing the therapeutic options of primary laryngectomy (pLE) vs. primary radio(system)therapy (pR(S)T) in patients with locally advanced laryngeal and hypopharyngeal carcinoma and thus little clear scientific evidence to decide which patients will benefit most from which procedure. Aim was to compare survival between the therapeutic options and to learn from the limitations of this study, especially in the context of improved clinical assessment. The clinical data of patients treated between January 2010 and February 2022 were obtained from the electronic database of the University Hospital Regensburg. Overall survival (OS) and progression-free survival (PFS) were compared between the treatment groups. The study included 193 patients (pLE n = 68, pR(S)T, n = 125). Median OS was 31.2 months and median PFS was 24.7 months with no significant difference between the treatment groups (p >.050). Patients who did not receive complete treatment as recommended by the tumor conference (n = 47, 24.4%) had a higher risk of death (p =.024). The results of our study are consistent with the survival data reported in the literature. More detailed systematic data in clinical routine (e.g. relevant comorbidities) are required to ensure guideline-based recommended therapy. [ABSTRACT FROM AUTHOR]

Simple Summary: While males exhibit higher incidence and mortality rates for most non-sex-specific cancers compared to females, the reasons behind these differences remain unclear. By analyzing the male-to-female rate ratios (MF IRRs) of non-sex-specific cancers by race and ethnicity, this research aims to shed light on whether sex-based differences are rooted in intrinsic biological variations or environmental exposures. Similarities of MF IRRs across race and ethnicity may suggest underlying biological variations that drive sex differences, while variations in MF IRRs may point to external factors driving these incidence differences. The results may help us understand the etiology of non-sex-specific cancers and the complex interplay between biology and environment in cancer development. Men have 2–3 times the rate of most non-sex-specific cancers compared to women, but whether this is due to differences in biological or environmental factors remains poorly understood. This study investigated sex differences in cancer incidence by race and ethnicity. Cancer incidence data from the Surveillance, Epidemiology, and End Result (SEER) program (2000–2019) were used to calculate male-to-female incidence rate ratios (MF IRRs) for each cancer site, stratified by race and ethnicity, and age-standardized to the 2000 U.S. population for individuals ages ≥ 20 years. Among 49 cancer sites, 44 showed male predominance (MF IRR > 1), with seven inconsistencies across race and ethnicity, including cancers of the lip, tongue, hypopharynx, retroperitoneum, larynx, pleura cancers, and Kaposi sarcoma. Four cancers exhibited a female predominance (MF IRR < 1), with only gallbladder and anus cancers varying by race and ethnicity. The MF IRRs for cancer of the cranial nerves and other nervous system malignancies showed no sex differences and were consistent (MF IRR = 1) across race and ethnicity. The MF IRRs for most cancers were consistent across race and ethnicity, implying that biological etiologies are driving the observed sex difference. The lack of MF IRR variability by race and ethnicity suggests a minimal impact of environmental exposure on sex differences in cancer incidence. Further research is needed to identify biological drivers of sex differences in cancer etiology. [ABSTRACT FROM AUTHOR]

Simple Summary: Personalized cancer medicine is based on the right classification of patients that can, then, be treated according to their specific characteristics. This is accomplished by the use of biological markers, so the identification of reliable biomarkers is a primary goal of clinical research. Here, we present two RNA molecules (named MDL1 and MDL1AS) that are generated in the mitochondria and have been heretofore neglected due to a glitch in the official human genome. Both molecules are good prognostic biomarkers in rectal cancer, meaning that their expression can predict which patients will survive more than 5 years after treatment. In addition, MDL1AS is also a good diagnostic biomarker (can distinguish people with/without the disease) for diverse cancers, including those of the colon, rectum, breast, and larynx. Experiments in cancer cells in culture show that these RNAs regulate several hallmarks of cancer, such as mitochondrial function, cell growth, and migration. Non-coding RNAs provide new opportunities to identify biomarkers that properly classify cancer patients. Here, we study the biomarker status of the mitochondrial long non-coding RNAs, MDL1 and MDL1AS. Expression of these genes was studied in public transcriptomic databases. In addition, a cohort of 69 locally advanced rectal cancer (LARC) patients with a follow-up of more than 5 years was used to determine the prognostic value of these markers. Furthermore, cell lines of colorectal (HCT116) and breast (MDA-MB-231) carcinoma were employed to study the effects of downregulating MDL1AS in vitro. Expression of MDL1AS (but not MDL1) was significantly different in tumor cells than in the surrounding tissue in a tumor-type-specific context. Both MDL1 and MDL1AS were accurate biomarkers for the 5-year survival of LARC patients (p = 0.040 and p = 0.007, respectively) with promising areas under the curve in the ROC analyses (0.820 and 0.930, respectively). MDL1AS downregulation reduced mitochondrial respiration in both cell lines. Furthermore, this downregulation produced a decrease in growth and migration on colorectal cells, but the reverse effects on breast cancer cells. In summary, MDL1 and MDL1AS can be used as reliable prognostic biomarkers of LARC, and MDL1AS expression provides relevant information on the diagnosis of different cancers. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Reduced saliva production or changes in the quality of saliva are major causes of xerostomia as a perceptual disease. Purpose: This study aimed to measure validity and reliability of the Persian version of the xerostomia inventory (XI) questionnaire. Materials and Method: This cross-sectional study was performed in Kerman in 2021. The sample size for this study was 100 people. To test the discriminant validity of XI, 50 healthy people (control group) and 50 people undergoing or recovering from laryngeal radiation (xerostomia group) were chosen. Cronbach's alpha coefficient was used to determine internal consistency, and the intra-cluster correlation (ICC) coefficient was used to determine test-retest reliability after two weeks. To evaluate the concurrent validity, the relationship between the total score of the questionnaire and the golden question, which was defined as “How often do you have dry mouth?” was measured. Results: Cronbach's alpha and ICC coefficient for the total XI score were 0.84 and 0.95, respectively. The mean ages of patients in the radiotherapy group and the healthy participants were 59±7.5 and 41.1±6.6 years, respectively. Participants who were having or had had laryngeal radiotherapy had a significantly higher mean total XI score than healthy individuals (p< 0.001). Conclusion: The Persian version of the Xerostomia Inventory is a valid and reliable tool for assessing xerostomia. [ABSTRACT FROM AUTHOR]

Objective: This study sought to retrospectively examine the clinical outcomes of patients treated for supraglottic laryngeal cancer at a single center over a decade, assess the efficacy of surgical interventions, and evaluate survival rates in comparison to current literature. Materials and Methods: A retrospective analysis was conducted on 84 patients diagnosed with supraglottic laryngeal cancer who underwent surgical treatment between January 2008 and December 2018. Nonlaryngeal head and neck malignancies and inaccessible patient records were excluded. The study evaluated factors including tumor location, tumor stage, lymph node metastasis, surgical approach, complications, histopathological findings, and adjuvant therapy. Statistical analysis involved descriptive methods, frequencies, and ratios, with outcomes compared to existing literature. Results: The cohort primarily consisted of male patients (91.7%) with an average age of 58.04 years. Squamous cell carcinoma was the predominant histopathological type (98.8%), exhibiting various degrees of differentiation. Most patients presented with advanced-stage disease (III or IV), with 53.6% undergoing total laryngectomy. Neck dissection was performed in 95.2% of cases, and 69% received postoperative radiotherapy. The 5-year overall survival rate was 72.2%, with a recurrence rate of 7.1%. Conclusion: This study reveals that supraglottic laryngeal cancer, predominantly affecting older males, is frequently diagnosed at advanced stages. Surgical intervention resulted in a 5-year survival rate consistent with existing literature. Despite the limitation of its retrospective design and the small, single-center sample, the findings support current treatment modalities while underscoring the importance of early detection and further research. [ABSTRACT FROM AUTHOR]

Simple Summary: The use of synthetic patient data can help address patient privacy concerns and the general availability of clinical data. It can overcome the challenges associated with obtaining real patient data for use in medical research, healthcare analytics, and clinical decision support. We propose an approach to provide synthetic patient data for laryngeal cancer, a relatively rare but complex disease. We adapted an existing synthesis technology to produce realistic prevalence and age distributions in the generated patient datasets. We verified the methodology and validated the results using real patient data from a German cancer registry. Background: Obtaining large amounts of real patient data involves great efforts and expenses, and processing this data is fraught with data protection concerns. Consequently, data sharing might not always be possible, particularly when large, open science datasets are needed, as for AI development. For such purposes, the generation of realistic synthetic data may be the solution. Our project aimed to generate realistic cancer data with the use case of laryngeal cancer. Methods: We used the open-source software Synthea and programmed an additional module for development, treatment and follow-up for laryngeal cancer by using external, real-world (RW) evidence from guidelines and cancer registries from Germany. To generate an incidence-based cohort view, we randomly drew laryngeal cancer cases from the simulated population and deceased persons, stratified by the real-world age and sex distributions at diagnosis. Results: A module with age- and stage-specific treatment and prognosis for laryngeal cancer was successfully implemented. The synthesized population reflects RW prevalence well, extracting a cohort of 50,000 laryngeal cancer patients. Descriptive data on stage-specific and 5-year overall survival were in accordance with published data. Conclusions: We developed a large cohort of realistic synthetic laryngeal cancer cases with Synthea. Such data can be shared and published open source without data protection issues. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this article is to review the wound healing process of the vocal fold following phonomicrosurgery to remove benign vocal fold lesions in professional voice users. Understanding this process and the risk of developing scar tissue at the injury site is important for treatment of these individuals. This review also highlights special considerations during the post-injury rehabilitation period and the unique vocal loading tasks and needs of performing voice users. The goal of this article is to provide clinical tools for wound healing education to nonvoice-specialized speech-language pathologists to inform their rehabilitation of the professional and performing voice user. Conclusions: Implications intrinsic to vocal fold physiology and the stages of wound healing necessitate the avoidance of scar tissue with a rehabilitation plan tailored to the unique vocal loading demands of professional and performing voice users. There is a need to develop specific rehabilitation protocols that are genre-specific to aid in the individual treatment of the elite vocal athlete. [ABSTRACT FROM AUTHOR]

Background: The main cause of voice hoarseness is vocal cord palsy (VCP) that may be induced by many diseases that could be due to local laryngeal or extra laryngeal causes, including neoplastic and non-neoplastic entities. Normal vocal cords 18F-fluorodeoxyglucose (FDG) activity should be symmetric and of low grade higher than the mediastinal background uptake. Vocal cords asymmetrical FDG uptake was a well-known finding in patients with VCP. When recurrent laryngeal nerve (RLN) palsy is suspected, FDG PET and computed tomography (CT) findings can give strong evidence of diagnosis, with ability to diagnose the underlying extra laryngeal neoplastic etiology. Our aim was to assess the sensitivity and accuracy of hybrid FDG PET CT scan in diagnosis of VCP secondary to an extra laryngeal neoplastic cause. Methods: A retrospective study for 50 patients, presented with hoarseness of voice, referred from Otorhinolaryngology department to outpatient clinical oncology units, with clinically suspected extra laryngeal neoplastic causes of VCP. Left lung cancer was detected in 52% of patients which was the most frequent cause, 10% had right lung cancer, 8% had thyroid cancer, 6% had mediastinal lymphoma, 6% had metastatic mediastinal lymph nodes from breast cancer, and 6% had esophageal carcinoma. Results: PET CT scan versus CT scan showed true positive results in (44 vs. 29 patient), true negative results in 5 patients in both scans, and false negative in (1 vs. 16 patient), with no false positive in either. Thus, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for PET CT scan versus CT scan were 98% vs. 68%, 100% for both scans, 100% for both scans, 83.3% vs. 23.8%, and 86% vs. 56%, respectively. Conclusions: FDG PET CT scan plays an important role in diagnosis of oncology-related extra laryngeal causes of VCP, with higher sensitivity, negative predictive value, and accuracy than CT scan. FDG PET CT scan should be included in the workup of VCP if extra laryngeal oncological cause is suspected. [ABSTRACT FROM AUTHOR]

Aims: Carbohydrate antigen 199 (CA199) is a standard tumor marker, and recent studies have found elevated in CA199 levels in patients with diabetes. However, there is no systematic measurement and comparison of serum CA199 levels in patients with diabetes and cancer. Here, a detailed description of the changes in serum CA199 levels in patients with type 2 diabetes and various cancers was explored. Methods: A total of 5,641 participants were screened for clinical laboratory test results of serum CA199 levels over the past three years (2020–2023). This study included 2,464 healthy controls, 688 patients with type 2 diabetes, and 2,489 patients with 16 different types of cancer. Each type of cancer had more than 30 independent serum CA199 level test results. The serum CA199 levels were compared between cancer groups, type 2 diabetes patients, and healthy controls. Additionally, the CA199 levels of cancer patients were compared with those of patients with type 2 diabetes. Results: The serum CA199 levels of esophagus cancer, lung cancer, pancreatic cancer, ovarian cancer, breast cancer, rectum cancer, prostate cancer, bladder cancer, liver cancer, gastric cancer, cervical cancer, colon cancer, lymphoma, thyroid cancer, intracranial tumors, and nasopharyngeal laryngeal cancer were found to be elevated compared to healthy controls (P < 0.01). In addition, the serum CA199 levels of patients with type 2 diabetes were also significantly elevated compared to healthy controls (P < 0.01). Moreover, the degree of elevation in serum CA199 levels in patients with type 2 diabetes was not significantly different from that observed in some types of cancer, such as esophagus cancer (P = 0.163), breast cancer (P = 0.927), prostate cancer (P = 1.000), bladder cancer (P = 0.406), Lymphoma (P = 0.975), thyroid cancer (P = 1.000), intracranial tumors (P = 0.161), nasopharyngeal and laryngeal cancer (P = 1.000). Conclusions: Serum CA199 levels also increase in type 2 diabetes, and the magnitude of the increase is similar to that seen in some cancers. [ABSTRACT FROM AUTHOR]

Objective: Image enhancement systems are important diagnostic tools in the detection of laryngeal pathologies. This study aimed to compare three different image enhancement systems: professional image enhancement technology, Image1 S and narrow-band imaging. Method: Using the three systems, 100 patients with laryngeal lesions were investigated using a flexible and a 30° rigid endoscope. The lesions were diagnosed by three experts and classified using the Ni classification. The findings were compared. Results: Lesions classified as 'benign' were histopathologically confirmed in 50 per cent of patients, malignant lesions were confirmed in 41 per cent and recurrent respiratory papillomatosis were confirmed in 9 per cent. There was no significant difference between the experts' assessments of each image enhancement system. Conclusion: The three systems give comparable results in the detection of laryngeal lesions. With two additional systems, more users can perform image-enhanced endoscopy, resulting in a broadly available tool that can help to improve oncological assessment. [ABSTRACT FROM AUTHOR]

Early glottic cancer can be treated with laser resection or radiotherapy. In an earlier study, we found that voice function after laser resection was inferior to that after radiotherapy. This study was designed to determine if reduced margins at laser resection improved voice function without impairing oncologic results. A total of 268 patients with previously untreated T1–T2 glottic carcinoma were studied. They were primarily treated with either radiotherapy (n = 119) or laser resection (n = 149). Survival, need for additional treatment (radiotherapy and/or total layngectomi) and voice function was compared. Median follow up time was 7 years with range 0.5–16.6. There was no difference in the overall survival (p =.065) or disease-specific survival. (p =.126). After radiotherapy 32/119 patients and after laser resection 57/149 patients had recurrence. Total rate of laryngectomy was 24% in the radiotherapy group, and 8% in the laser resection group (p =.001). Voice analysis (T1A) showed more roughness in the radiotherapy group, otherwise no difference. By reducing the surgical margins, we have achieved a better voice function (T1A) but more patients have needed repeated laser excisions and some have also needed supplementary radiotherapy. The risk of laryngectomy and survival were apparently not affected. [ABSTRACT FROM AUTHOR]

Simple Summary: Oral infection with high-risk human papillomaviruses is one of the known risk factors for oropharyngeal cancer. Human papillomavirus-related oropharyngeal cancer is a rising trend in many Western countries. Hong Kong is a vibrant Chinese cosmopolitan city in East Asia where data on the trend of change in human papillomavirus-related oropharyngeal cancer are not available. This study found that oropharyngeal cancer cases have increased persistently over the last three decades in Hong Kong, despite a notable decrease in other head and neck cancers such as the laryngeal cancer. By testing a series of cancer samples collected over the past several years, this study found that the proportion of oropharyngeal cancer infected with high-risk human papillomaviruses has increased substantially over the last decade. Strategies to prevent oral human papillomavirus infection and its associated diseases including oropharyngeal cancer are urgently needed. Research on the early detection of oropharyngeal cancer is a priority. The incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is rising in the West, but little is known in Asia. This study elucidated changes in the incidence and HPV-positive portion of OPSCC in Hong Kong. Data from population-based cancer registry were used to analyze the incidence of OPSCC in association with other head and neck cancers. Archived tumor tissues were tested for HPV. From 1986 to 2020, there was a marked decrease in the incidence of nasopharyngeal and laryngeal cancers, but a persistent increase in OPSCC from 36 cases in 1986 to 116 cases in 2020. The average positive rate for high-risk HPV was 36.1% (112/310) among OPSCC diagnosed in 2010–2020. The HPV-positive rate in recent years was significantly higher than earlier cases (tonsil SCC: 64.7% (55/85) in 2016–2020 vs. 40.4% (19/47) in 2010–2015, p = 0.007). Patients with HPV-positive tonsil cancers were significantly younger than those negative (mean [SD]: 58.9 [9.9] vs. 64.3 [13.3] years, p = 0.006), but no significant difference was observed between genders. A persistent increase in the incidence of oropharyngeal cancer over the last few decades was observed in Hong Kong, which can be explained by the remarkable increase in HPV-positive tonsil cancers. [ABSTRACT FROM AUTHOR]

Simple Summary: Laryngeal cancer poses a major global health burden, with late-stage diagnoses contributing to decreased survival rates. Recently, deep learning and deep convolutional neural network models have exhibited significant attention in the diagnosis of various diseases like skin cancer and diabetic retinopathy. Therefore, this study focuses on the design and development of a deep learning-based laryngeal cancer detection and classification model. The proposed model exploited a hyperparameter-tuned EfficientNetB0 model with a multi-head bidirectional gated recurrent unit for classification. In addition, the Dwarf Mongoose Optimization algorithm is applied for the hyperparameter tuning process. The experimental results stated that the proposed model is found to be an accurate and reliable approach for automated detection of laryngeal cancer. Laryngeal cancer (LCA) is a serious disease with a concerning global rise in incidence. Accurate treatment for LCA is particularly challenging in later stages, due to its complex nature as a head and neck malignancy. To address this challenge, researchers have been actively developing various analysis methods and tools to assist medical professionals in efficient LCA identification. However, existing tools and methods often suffer from various limitations, including low accuracy in early-stage LCA detection, high computational complexity, and lengthy patient screening times. With this motivation, this study presents an Automated Laryngeal Cancer Detection and Classification using a Dwarf Mongoose Optimization Algorithm with Deep Learning (ALCAD-DMODL) technique. The main objective of the ALCAD-DMODL method is to recognize the existence of LCA using the DL model. In the presented ALCAD-DMODL technique, a median filtering (MF)-based noise removal process takes place to get rid of the noise. Additionally, the ALCAD-DMODL technique involves the EfficientNet-B0 model for deriving feature vectors from the pre-processed images. For optimal hyperparameter tuning of the EfficientNet-B0 model, the DMO algorithm can be applied to select the parameters. Finally, the multi-head bidirectional gated recurrent unit (MBGRU) model is applied for the recognition and classification of LCA. The simulation result analysis of the ALCAD-DMODL technique is carried out on the throat region image dataset. The comparison study stated the supremacy of the ALCAD-DMODL technique in terms of distinct measures. [ABSTRACT FROM AUTHOR]

Objective: Survival of laryngeal cancer is decreasing; thus, optimal treatment selection is paramount. Specifically, T3 disease survival appears similar with surgical or non-surgical management; however, the implications of vocal cord fixation on treatment selection and survival are unknown. This study seeks to determine if surgical treatment of patients with T3M0 laryngeal cancer with vocal cord fixation is associated with superior survival compared to non-surgical treatment. Methods: The National Cancer Database (NCDB) was queried for all T3M0 laryngeal carcinoma cases from 2004 to 2015, whose treatment included surgery or radiation therapy. Cases were stratified by cord fixation status and overall survival was compared using multivariable methods based on surgical versus non-surgical management. Results: Non-surgical management was more common, regardless of cord fixation status (84% in fixed and 79% in mobile). Cord fixation itself did not influence survival; however, surgical management had a significant survival benefit in the fixed cohort (HR = 0.843; 95% CI: 0.738, 0.962). Conclusion: In this large observational cohort study of T3M0 laryngeal cancer, those with fixed cords had superior survival when managed surgically. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to evaluate visual gaze patterns and the ability to correctly identify cancer among participants of different experience levels when viewing benign and malignant vocal cord lesions. Methods: Thirty-one participants were divided into groups based on level of experience. These included novice (medical students, PGY1-2 otolaryngology residents), intermediate (PGY3-5 otolaryngology residents, gastroenterology fellow), advanced practice providers (physician assistants, nurse practitioners, and speech language pathologists), and experts (board-certified otolaryngologists). Each participant was shown 7 images of vocal cord pathology including glottic cancer, infectious laryngitis, and granuloma and asked to determine the likelihood of cancer on a scale of certain, probable, possible, and unlikely. Eye tracking data were collected and used to identify the area of interest (AOI) that each participant fixated on first, fixated on the longest, and had the greatest number of fixations. Results: No significant differences were seen among groups when comparing AOI with first fixation, AOI with longest fixation, or AOI with most fixations. Novices were significantly more likely to rate a low likelihood of cancer when viewing infectious laryngitis compared to more experienced groups (P <.001). There was no difference in likelihood of cancer rating among groups for the remaining images. Conclusions: There was no significant difference in gaze targets among participants of different experience levels evaluating vocal cord pathology. Symmetric appearance of vocal cord lesions may explain differences seen in likelihood of cancer rating among groups. Future studies with larger sample sizes will better elucidate gaze targets that lead to accurate diagnosis of vocal cord pathology. [ABSTRACT FROM AUTHOR]

Background: This study aims to compare the performance of intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) in treating laryngeal cancer. Method: In this retrospective dosimetric study, 15 patients diagnosed with locally advanced laryngeal cancer (LALC) were selected. The dosimetric performance of the two techniques was analyzed using 6 MV X-rays, based on dose-volume histograms for primary and boost planning target volumes (PTVp and PTVb, respectively), relevant organs at risk (OARs), mean Dose (Dmean), maximum Dose (Dmax), 95% Dose (D95), 2% Dose (D2%), 5% Dose (D5%), monitor units per segment (MU/segment), number of MU/cGy, treatment delivery time, along with conformity and homogeneity indices. Results: Both techniques were able to achieve favorable equivalent uniform doses and low doses to OARs. The average total number of monitor units for IMRT was significantly greater than that for VMAT (1724.5 ± 249.5 and 475.3 ± 47.0, respectively for PTVp and 601.4 ± 81.7 and 458.0 ± 62.6, respectively for PTVb). The modulation factor (MU/cGy) of IMRT was significantly greater than that for VMAT for both the primary and the boost phases. The mean treatment delivery time for all cases of IMRT was significantly longer than that of VMAT. Conclusion: The primary distinction between IMRT and VMAT in the treatment of LALC is that VMAT requires significantly fewer monitor units (one-third) compared with IMRT. This reduction contributes to a decrease in treatment time, which in turn positively impacts patient comfort and the accuracy of treatment. [ABSTRACT FROM AUTHOR]

Summary: The presentation of acute and rapidly deteriorating airway pathology can be a highly challenging situation for any hospital team. Cricoid chondromas are a challenging and potentially unfamiliar airway pathology requiring the combined expertise of anaesthetists, ear, nose and throat surgeons and a wider peri‐operative team familiar with managing airway emergencies. Airway lesions which cause rigid and fixed stenosis require careful management and present additional challenges compared to soft tissue lesions. An important consideration in fixed airway stenosis is the external diameter of tracheal tubes compared to the diameter of the airway at its narrowest point. These are challenging cases to manage and a multi‐disciplinary approach to the safe management of unfamiliar and critical airway pathology should be adopted. [ABSTRACT FROM AUTHOR]

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Stridor is an important symptom which should not be missed, especially in a child. The etiology could be multifactorial and will require a comprehensive investigation into its management. In this case, we discuss the clinician's dilemma in reaching a diagnosis due to various factors which were present in a single patient. This rare benign laryngeal squamous polyp was eventually diagnosed in an 11-week-old boy who presented with acute stridor. The diagnostic dilemma we discuss in this case was due to multiple maternal and fetal factors. He was a premature baby, intubated at birth, there was a maternal tuberculosis infection and he also had a cutaneous hemangioma which were all part of the diagnostic dilemma faced in his management which eventually led to an acquired subglottic stenosis. Our discussion will focus on how a thorough and proper evaluation is needed especially when there are many deceptive clues or signs present in a patient. [ABSTRACT FROM AUTHOR]

Objective: To investigate epidemiological, clinical and oncological outcomes of patients with laryngeal verrucous carcinomas (LVC). Methods: Two independent authors investigated PubMed, Scopus and Cochrane Library for studies dedicated to epidemiological, clinical and oncological outcomes of patients with LVC. The following outcomes were investigated with PRISMA criteria: age; gender; tobacco/alcohol consumption; HPV infection; anatomical, pathological, therapeutic and survival outcomes. Studies were analyzed for bias through a validated clinical tool. Results: Of the 212 identified articles, 15 retrospective studies and one prospective uncontrolled study met our inclusion criteria. Three studies reported findings from national databases. The males/females ratio is 9/1. Mean age was 60.3 years, which was younger compared to other laryngeal malignancies. The alcohol, cigarette overuse and the HPV status of patients were lacking in most studies. Glottis and supraglottis were the most common anatomical locations, corresponding to 78.7% and 12.4% of cases, respectively. The main therapeutic approaches consisted of surgery, radiotherapy, surgery followed by radiotherapy. Treatments reported 5-year overall survival and disease-specific survival of 86.3 and 90.8, respectively. The 5- and 10-year local control rate were 83.6 and 72.6, respectively. The 10-year disease-specific survival was 80.2. Heterogeneity between studies was found for inclusion criteria, comorbidity data, and treatments. Conclusion: LVC is a rare laryngeal cancer associated with better survival and recurrence outcomes than laryngeal squamous cell carcinoma. The role of radiotherapy in the treatment regimen needs to be investigated in future prospective controlled studies. [ABSTRACT FROM AUTHOR]

Objectives: Despite the increasingly modern surgical techniques in the oncology field, the factors that influence postoperative prognosis in patients with hypopharyngeal and laryngeal carcinoma (HLC) remain unclear. The study aimed to evaluate the factors influencing the prognosis of HLC patients with pathological diagnosis of squamous cell carcinoma, and the findings are intended to direct follow-up management strategies. Methods: A retrospective cohort study was performed. The study population included 407 postoperative patients with HLC from 2011 to 2015. Univariate and multivariate analyses were used to examine the prognostic factors identified. Results: Based on univariate analysis results, smoking and alcohol history, tumor differentiation, preoperative radiotherapy, primary tumor sites, flap reconstruction, lymph node invasion (LNI), and preoperative albumin levels (PAL) significantly affects the prognosis of HLC patients (P <.05). Meanwhile, multivariate analysis revealed that smoking pack-year (OR = 1.002, 95% CI = 1.001 ∼ 1.003), primary tumor sites (OR = 6.241, 95% CI = 1.715 ∼ 18.433), LNI (OR = 2.869, 95% CI = 1.095 ∼ 8.743), and PAL (OR =.020, 95% CI =.004 ∼ 0.104) were associated with complications. Tumor differentiation (OR = 0.650, 95% CI =.383 ∼ 0.855), primary tumor sites (OR = 12.392, 95% CI = 3.290 ∼ 26.679), LNI (OR = 16.323, 95% CI = 2.726 ∼ 47.729), preoperative radiotherapy (OR = 9.300, 95% CI = 3.182 ∼ 27.181), and PAL (OR =.321, 95% CI =.141 ∼.732) were associated with overall survival rates. Conclusion: Smoking and alcohol history, tumor differentiation, LNI, primary tumor sites, flap reconstruction, PAL, and preoperative radiotherapy are crucial factors that influence the postoperative prognosis of patients with HLC. In addition, a monogram of five factors was established to predict the survival rates of HLC patients. [ABSTRACT FROM AUTHOR]

Chronic infectious laryngitis is a clinical mimic of laryngeal carcinoma which can be due to bacterial or fungal aetiology. Both conditions present with non-specific symptoms with leucoplakia on examination. The role of biopsy of laryngeal lesions in the absence of risk factors of laryngeal carcinoma is debatable as it responds to antifungal therapy. This study aimed to review the predisposing factors and role of biopsy in chronic infectious laryngitis. A retrospective review of all cases of chronic infectious laryngitis presented to our centre between 2018 and 2021 were conducted. Clinical features, risk factors, antifungal therapy and its response were reviewed. All cases of chronic infectious laryngitis avoided the need of biopsy while had successful empirical antifungal therapy except for one refractory case. Biopsy of the refractory case was negative for malignancy and the cultureproven Staphylococcus aureus laryngitis was successfully treated with antibiotics. Empirical antifungal therapy in cases of chronic infectious fungal laryngitis with close serial follow-up had good outcome. Biopsy should be reserved for refractory cases to exclude malignancy and guide further antimicrobial therapy. [ABSTRACT FROM AUTHOR]

Introduction: Malignant transformations may result from gene dysregulation caused by genetic and epigenetic modifications. The use of miRNAs to treat cancer depends on the downregulation or upregulation of the miRNAs responsible for carcinogenesis (proliferation, angiogenesis, invasion, metastasis), providing the opportunity to suppress tumors. The purpose of this review is to list miRNAs identified so far as biomarkers in laryngeal squamous cell carcinoma (LSCC). This listing may help in predicting the evolution of miRNAs and developing anti-miRNAs and miRNA-mimics as anti-cancer therapies. Material and methods: Relevant publications from 2008 to 2022 were retrieved from the PubMed and Google Scholar databases, using the key words miRNA (PubMed -- 149,294 results; Google Scholar -- 205,000 results), laryngeal squamous cell carcinoma (PubMed -- 33,191 results; Google Scholar -- 17,900 results), laryngeal squamous cell carcinoma biomarkers (PubMed -- 6249 results; Google Scholar -- 18,000 results), laryngeal squamous cell carcinoma miRNA (PubMed -- 1338 results; Google Scholar -- 17,500 results). Eventually 51 papers were selected for review. Results: We identified 51 studies which have detected miRNA-based biomarkers for LSCC, and they are broadly reviewed here. Conclusions: The identified laryngeal squamous cell-specific miRNA biomarkers appear to be promising for the detection, predicted course, and treatment of LSCC. [ABSTRACT FROM AUTHOR]

The article focuses on a case of a 2-month-old male with recurrent stridor, ultimately diagnosed with a left subglottic hemangioma. It discusses the characteristics and diagnosis of infantile subglottic hemangiomas, highlighting the importance of differentiating them from croup, particularly in cases of persistent stridor during viral transmission.

Background: Laryngeal tumor is the most commonly identified malignancy in head and neck cancers, containing 2.4% of all cancers, and is the 11th most prevalent and fatal cancer in the world. Previous research has revealed that microRNAs (miRNAs) have a significant role in the progression of laryngeal tumors. Additionally, research focuses on the association with the clinical function of miRNA in malignancy. Objectives: Based on previous research, miR-132, miR-302, miR-126, and miR-205 have potential roles in the tumor development of the LSCC. Then, in the current study, we pointed to study if there are any significant alters in the expression of microRNAs and whether they have any significant possibility as a diagnostic or prognostic factor for laryngeal squamous cell carcinoma. Methods: From 30 LSCC patients, we have collected tumor and marginal healthy tissues through laryngectomy. Total RNA extraction from the marginal healthy and malignancy tissues was done. Next, we control the quality of the RNAs and, then, synthesize cDNA. Lastly, the expression of the miRNAs was evaluated by qPCR. The expression level of genes and their association with the patient's clinicopathological features were studied, using related statistical tests. Results: miR-132 (P = 0.0001, fold change: 1.28) and miR-302 (P = 0.0001, fold change: l.o5) are significantly up-regulated in tumor tissues compared to normal peripheral tissues. Furthermore, we revealed that miR-205 (P < 0.0001, fold change: 0.241) and miR-126 (P = 0.0001, fold change: 0.251) are low expressed in LSCC cancer tissue. Between these miRNAs, gust expression of the miR-205 had no relationship with clinical-pathological characteristics in malignancy tissue. Conclusions: The results of the current study showed the possibility of miR-302, miR-132, miR-126, and miR-205 as diagnostic or prognostic factors in LSCC. [ABSTRACT FROM AUTHOR]

Background: Despite the high prevalence of head and neck cancers in Iran, no studies have been conducted to investigate the relationship between vitamin D levels and these cancers. Many Iranians suffer from vitamin D deficiency, which underscores the importance of conducting these studies in Iran. Objectives: This study aims at investigating the relationship between vitamin D levels and laryngeal cancer. Methods: This 1: 1 matched case-control study included 216 patients in Mashhad, Iran, who had not consumed vitamin D supplements for 3-months before study onset. Participants were grouped in 2 categories; the case group, which consisted of patients with laryngeal cancer whose squamous cell carcinoma was confirmed pathologically for the first time (new cases), and the control group, which consisted of individuals who did not have any cancer at the time of the study, confirmed by indirect laryngoscopy, and were identical to the patient group in terms of other risk factors for laryngeal cancer (smoking and alcohol abuse). First, the relevant checklist (including age, occupation, consumption of tobacco, alcohol use, etc., history of contact with mustard gas, wood, stone, metal, and cement industry, as well as history of reflux in the individual and cancer in relatives) was completed for all case and control group members. After taking blood samples, they were evaluated for serum levels of vitamin D3. Data were analyzed using chi-square, Mann-Whitney U or independent sample t-tests. Logistic regression was also used to determine the relation between vitamin D level and laryngeal cancer. Results: Mean age, sex and risk factors of laryngeal cancer were not significantly different between the two groups. Vitamin D level was significantly lower in patients with laryngeal cancer compared to control group (16.02 ± 3.62 ng/mL vs 25.19 ± 3.40 (P< 0.001)). Logistic regression analysis showed that vitamin D level is independently related to laryngeal cancer and has a protective effect on this neoplasm (OR= 0.54, 95%CI: 0.46 - 0.63, P < 0.001). Conclusions: A lower vitamin D level may be related to laryngeal cancer. However, the role of vitamin D deficiency as a risk factor for head and neck cancers and whether the treatment of this condition could prevent the incidence of such cancers is a matter of future investigations. [ABSTRACT FROM AUTHOR]

Laryngeal cancer ranks as the second most prevalent upper airway malignancy, following Lung cancer. Although some progress has been made in managing laryngeal cancer, the 5-year survival rate is disappointing. The gradual increase in the incidence of second primary tumors (SPTs) plays a crucial role in determining survival outcomes during long-term follow-up, and the esophagus was the most common site with a worse prognosis. In clinical practice, the treatment of esophageal second primary tumors (ESPT) in patients with laryngeal squamous cell carcinoma (LSCC) has always been challenging. For patients with synchronous tumors, several treatment modalities, such as radiotherapy, chemotherapy and potentially curative surgery are necessary but are typically poorly tolerated. Secondary cancer therapy options for metachronous patients are always constrained by index cancer treatment indications. Therefore, understanding the clonal origin of the second primary tumor may be an important issue in the treatment of patients. LSCC cells demonstrate genetic instability because of two distinct aetiologies (human papillomavirus (HPV)-negative and HPV-positive) disease. Various etiologies exhibit distinct oncogenic mechanisms, which subsequently impact the tissue microenvironment. The condition of the tissue microenvironment plays a crucial role in determining the destiny and clonal makeup of mutant cells during the initial stages of tumorigenesis. This review focuses on the genetic advances of LSCC, the current research status of SPT, and the influence of key carcinogenesis of HPV-positive and HPV-negative LSCC on clonal evolution of ESPT cells. The objective is to gain a comprehensive understanding of the molecular basis underlying the clonal origins of SPT, thereby offering novel perspectives for future investigations in this field. [ABSTRACT FROM AUTHOR]

Simple Summary: This retrospective study compares the diagnostic efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in detecting nodal disease with that of neck magnetic resonance imaging (MRI). It then measures the rate of change in therapy intent when relying on 18F-FDG PET/CT nodal staging results. In a group of 66 patients, our findings emphasize the importance of metabolic tumor volume and nodal size in distinguishing between benign and metastatic lymph nodes. These identified parameters present a promising avenue for reliably predicting nodal disease status, thereby offering robust imaging-based support for future research endeavors in this domain. This retrospective study examines the diagnostic accuracy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and neck magnetic resonance imaging (MRI) in detecting nodal metastasis for patients with laryngeal squamous cell carcinoma (LSCC) and assesses the predictive values of metabolic and structural features derived from 18F-FDG PET/CT. By involving 66 patients from 2014 to 2021, the sensitivity and specificity of both modalities were calculated. 18F-FDG PET/CT outperforms neck MRI for nodal disease detection, with 89% sensitivity, 65% specificity, and 77% accuracy for nodal metastasis (p = 0.03). On the other hand, neck MRI had 66% sensitivity, 62% specificity, and 64% accuracy. Approximately 11% of patients witnessed a change in their therapy intent when relying on 18F-FDG PET/CT nodal staging results. Analyzing the cohort for PET-derived metabolic and morphological parameters, a total of 167 lymph nodes (LN) were visualized. Parameters such as the LN maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and LN size were computed. Logistic regression and receiver operating characteristic (ROC) analyses were performed. Among the 167 identified cervical LNs, 111 were histopathologically confirmed as positive. ROC analysis revealed the highest area under the curve for LN MTV (0.89; p < 0.01), followed by LN size (0.87; p < 0.01). Both MTV and LN size independently predicted LN metastasis through multivariate analysis. In addition, LN MTV can reliably predict false-positive LNs in preoperative staging, offering a promising imaging-based approach for further exploration. [ABSTRACT FROM AUTHOR]